Objective: To compare the ultrasonographic features of calcified and non-calcified ductal carcinoma in situ (DCIS) of breast, and to explore the difference of the expression of estrogen receptor (ER) and human epidermal growth factor receptor-2 (Her-2). Methods A total of 148 patients with pathologically confirmed DCIS were retrospectively analyzed and divided into calcified DCIS group (n=66) and non-calcified DCIS group (n=82) according to the presence of microcalcification in ultrasonography. The differences of the ultrasonographic features, ER and Her-2 positive expression were analyzed. Results The signs of mass, ductal ectasia and elastographic scores showed statistically significant differences between the 2 groups (all P<0.05), while the signs of spiculation, posterior echo attenuation, resistance index and aspect ratio showed no statistically significant difference (all P>0.05). ER positive rate was 42.42% (28/66) in calcified DCIS group and 69.51% (57/82) in non-calcified DCIS group. The difference of ER positive rate between the two groups was statistically significant (P<0.01). Her-2 positive in calcified DCIS group was 30.30% (20/66), while in the non-calcified DCIS group was 14.63% (12/82; P=0.02). Conclusion The ultrasonographic features are different between calcified breast DCIS and non-calcified DCIS. Positive ER is more common in non-calcified DCIS, while high Her-2 expression is more common in calcified DCIS, indicating that calcified DCIS may have rather aggressive histological features.

Aim To construct TLR9 gene knockout mouse model and preliminarily identify the phenotypes. Methods The TLR9 knockout mice were established by CRISPR/Cas9 system. The genotype of knockout mice was identified by capillary gel electrophoresis, while the PCR product was sequenced to analyse the knockout efficiency. The mRNA and protein expression level of TLR9 were determined by qRT-PCR, Western blot and immunohistochemistry. Genetic traits, body weight and blood routine changes were also measured. Pathological changes of mouse tissues were observed by hematoxylin-eosin (HE) staining. Results PCR and sequencing results showed that the stable TLR9 gene knockout mice were generated. The TLR9 gene expres-sions of knockout mice in spleen and liver tissues were significantly lower than those of wild-type mice. The growth and breeding of TLR9 knockout mice were normal , as well as all indexes of body weight and peripheral blood routine. The histomorphological characteristics of TLR9 knockout mice showed no significant difference compare to wild-type mice. Conclusions The TLR9 knockout mice are successfully established, providing an experimental animal model for studying the biological functions and regulatory mechanisms of the TLR9.

Objective: To analyze the mortality and years of life lost (YLL) trends of cervical cancer in Tianjin, and provide references for the research and prevention programs of cervical cancer. Methods: Mortality rate, standard mortality rate, cumulative rate (0-74 years-old) and truncated rate (35-64 years-old) of cervical cancer from 1999 to 2015 were calculated. The annual percentage change of the mortality rate and YLL rate were analyzed by using Joinpoint regression analysis, and the trend in different age-groups were analyzed. Results: From 1999 to 2015, 1 741 cases died of cervical cancer in Tianjin, the average crude mortality rate was 2.15/100 000. The average age-standardized rate of (ASR) China and ASR world were 1.47/100 000 and 1.50/100 000 respectively. The average YLL was 3 347.97 person-years. Deaths occurred in those aged 0-34 years, 35-64 years and 65 years and over accounted for 3.10%, 57.84% and 39.06% of the total, respectively. The mortality rate of cervical cancer in urban area was higher than that in rural area, with a ratio of 1.37∶1 between urban area and rural area. The age-specific mortality rate of cervical cancer during 1999-2015 increased with age. Two peaks of mortality rate were observed in those aged 50 years and aged 75 years, during 2014-2015. From 1999 to 2011, the mortality rate of cervical cancer was stable (APC=-0.2%, P=0.80), but there was a rapid increase from 2011 to 2015 (APC=21.6%, P<0.01). But group aged 20-49 years, it showed an upward trend from 1999 to 2015 (APC=6.9%, P<0.01). For group aged 50-69 years, it showed a downward trend from 1999 to 2007 (APC=-9.2%, P<0.01), and an upward trend from 2007 to 2015 (APC=14.5%, P<0.01). For group aged 70 years and over, it showed a downward trend from 1999 to 2009 (APC=-10.2%, P<0.01), but the difference in the mortality were not significant from 2009 to 2015 (APC=7.8%, P=0.10). Since 2008, the YLL rate of cervical cancer in group aged 50-70 years had exceeded that in group aged >70 years and the gap gradually widened. Conclusions: There had been a rapid increase trend of cervical cancer mortality since 2011 in Tianjin. Women aged 50-70 years were the main group of life loss.
Adolescent ; Adult ; Aged ; China/epidemiology* ; Female ; Humans ; Incidence ; Middle Aged ; Mortality/trends* ; Regression Analysis ; Residence Characteristics ; Survival Rate/trends* ; Uterine Cervical Neoplasms/mortality* ; Young Adult

Objective: To investigate the peripheral blood mucosa-associated constant T cell(MAIT) expression in children with bronchial asthma and its relevance to severity. Methods: Ninety-eight children with bronchial asthma who were treated in Affliated Dongfeng Hospital from May 2016 to May 2019 were selected as the asthma group. Another 60 healthy children who underwent health checkup during the same period were as control group. The levels of MAIT were detected by flow cytometry analyzer using BD FACSAria II flow cytometry, and the lung function was detected by Yage lung function tester. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of peripheral blood MAIT for bronchial asthma. Pearson analysis was used to examine the relationship between MAIT cells and pulmonary function. Results: There were no significant differences in the general data of gender, age, and body mass index between the two groups (P>0.05). The asthma control test (ACT) score, the percentage of first second forced expiratory volume occupied estimated value (FEV₁%), the percentage of first second forced expiratory volume occupied forced vital capacity (FEV₁/FVC), the percentage of peak expiratory flowoccupied estimated value (PEF), and MAIT cells in asthma group were significantly lower than those in control group (P<0.05). Serum MAIT identified bronchial asthma and healthy controls with an area under curve (AUC) of 0.900, with a sensitivity of 82.65%, and a specificity of 85.00%. Serum MAIT identified the mild-sustained group and the healthy control group with an AUC of 0.910, with a sensitivity of 94.64%, and a specificity of 81.67%. Correlation analysis showed that MAIT cells in children with bronchial asthma were significantly positively correlated with pulmonary function indexes such as FEV₁%, FEV₁/FVC and PEF (r=0.159, 0.222, 0.213, P<0.05). Conclusions The peripheral blood MAIT in children with bronchial asthma is significantly reduced, which is related to the levels of lung function indicators. MAIT can be used as one of the indicators for the diagnosis and clinical prognosis of patients with bronchial asthma.

INTRODUCTIONWhile the readmission rate from community hospitals is known, the factors affecting it are not. Our aim was to determine the factors predicting unplanned readmissions from community hospitals (CHs) to acute hospitals (AHs).

MATERIALS AND METHODSThis was an observational prospective cohort study, involving 842 patients requiring post-acute rehabilitation in 2 CHs admitted from 3 AHs in Singapore. We studied the role of the Cumulative Illness Rating Scale (CIRS) organ impairment scores, the Mini-mental State Examination (MMSE) score, the Shah modified Barthel Index (BI) score, and the triceps skin fold thickness (TSFT) in predicting the rate of unplanned readmissions (UR), early unplanned readmissions (EUPR) and late unplanned readmissions (LUPR). We developed a clinical prediction rule to determine the risk of UR and EUPR.

RESULTSThe rates of EUPR and LUPR were 7.6% and 10.3% respectively. The factors that predicted UR were the CIRS-heart score, the CIRS-haemopoietic score, the CIRS-endocrine / metabolic score and the BI on admission. The MMSE was predictive of EUPR. The TSFT and CIRS-liver score were predictive of LUPR. Upon receiver operator characteristics analysis, the clinical prediction rules for the prediction of EUPR and UR had areas under the curve of 0.745 and 0.733 respectively. The likelihood ratios of the clinical prediction rules for EUPR and UR ranged from 0.42 to 5.69 and 0.34 to 3.16 respectively.

CONCLUSIONSPatients who have UR can be identified by the admission BI, the MMSE, the TSFT and CIRS scores in the cardiac, haemopoietic, liver and endocrine/metabolic systems.

Acute Disease ; therapy ; Aged ; Female ; Follow-Up Studies ; Hospitals, Community ; statistics & numerical data ; Hospitals, Special ; statistics & numerical data ; Humans ; Intensive Care Units ; statistics & numerical data ; Male ; Patient Readmission ; trends ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Singapore

A child developed pleuro-abdominal fistula after 2 years and 8 months on long-term peritoneal dialysis (PD). A comprehensive care package was offered to the child, including recognizing and monitoring the manifestation of pleuro-abdominal fistula, management during the temporary hemodialysis, monitoring the child's condition after the reinitiation of peritoneal dialysis, preventing the high intraperitoneal pressure, psychological supporting for the parents, training of PD related knowledge and practice, and offering nutrition guidance. After 8-week temporary hemodialysis, PD was reinitiated and the transition was smooth. The child was discharged free of any symptom after 14 days of reinitiation.

OBJECTIVETo reveal the molecular genetic mechanisms for the pathogenesis of glioblastoma (GBM) and determine which chromosomes or chromosomal regions may play a role in the pathogenesis of GBM or may harbor tumor suppressor genes (TSGs) associated GBM.

METHODSAn allelotype study of 21 cases of GBM was performed by polymerase chain reaction and loss of heterozygosity (LOH) analysis. Three hundred and eighty-two microsatellite markers covering all 22 autosomes were used. The mean genetic distance between two flanking markers is about 10 cM. Fluorescent dye-labeled primers and Perkin Elmer 377 DNA Sequencer were applied.

RESULTSLOH was observed on all chromosomal arms examined in this study. The LOH frequencies of 10q, 10p, 13q, 17p and 9p were the highest (>50%), on which high LOH frequencies were detected at the regions resided by the known TSGs including PTEN, DMBT1, p16, p15, p53 and Rb. The following commonly deleted regions were detected: 9p22-23, 10p12.2-14, 10q21.3, 13q12.1-14.1, 13q14.3-31, 17p11.2-12, 17p13, 3q24-27, 11p12-13, 14q31-32.3, 14q21-24.1, 22q13.2-13.3, 4q35, 4q31.1-31.2, 6qtel, 6q16.3.

CONCLUSIONThis study demonstrated that the pathogenesis of GBM is very complicated and associated with various molecular genetic abnormalities on lots of chromosomes. The chromosomal arms most closely relevant to the pathogenesis of GBM are 10q, 10p, 9p, 17p and 13q. Besides the well-known TSGs, such as PTEN, DMBT1, p16, p15, p53 and Rb, multiple unknown TSGs associated with GBM may be present on the commonly deleted regions observed for the first time in this study.

Adult ; Aged ; Chromosomes, Human ; genetics ; DNA, Neoplasm ; genetics ; Female ; Glioblastoma ; genetics ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged

OBJECTIVETo evaluate whether deletion of chromosome 14q is involved in the carcinogenesis of primary glioblastoma multiforme and to identify possibly common deletion regions. METHJODS: Fourteen fluorescent dye-labeled polymorphic markers were used and polymerase chain reaction-based microsatellite analysis was employed to investigate loss of heterozygosity (LOH) on chromosome 14q in 20 primary glioblastoma multiforme (GBM).

RESULTSTen of twenty (50%) GBM displayed LOH at one or more of the markers on chromosome 14q. Five tumors showed either LOH or non-informative on all markers tested. The most frequent LOH was observed at locus D14S65 (57.1%) on 14q32.1, and in the chromosomal region spanning from D14S63 (47.1%) to D14S74 (46.7%) on 14q23-31. None of the informative loci exhibited microsatellite instability.

CONCLUSIONSAllelic deletion on chromosome 14q plays an important role in the pathogenesis of GBM. Chromosomal regions at locus D14S65 on 14q32.1 and spanning from D14S63 to D14S74 on 14q23-31 may harbor multiple tumor suppressor genes associated with GBM.

Adult ; Aged ; Chromosomes, Human, Pair 14 ; Female ; Genes, Tumor Suppressor ; Glioblastoma ; genetics ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged

Objective: To investigate the status of immunization of National Immunization Program (NIP) and its adverse reaction rate in children with tuberous sclerosis. Method: Questionnaire survey was adopted to identify the vaccination coverage and its adverse events; 72 cases of children with tuberous sclerosis and 78 normal controls (healthy children completing age-appropriate NIP) admitted to Chinese People′s Liberation Army General Hospital from December 2014 to November 2015 were involved into this study. Result: The age-appropriate NIP coverage rate of tuberous sclerosis was 36%(26/72). The coverage rate of bacillus calmette-guerin (BCG), hepatitis B vaccine 1^st to 3^rd doses (HepB1-3), oral poliovaccine 1^st dose (OPV1), diphtheria, pertussis and tetanus 1^st dose (DPT1), DPT1-3, meningococcal polysaccharide vaccine group A (MPVA), measles amd rubella vaccine/measles vaccine 1^st dose (MRV/MCV1), and Japanese encephalitis vaccine 1^st dose (JEV1) were 100%(72 cases), 75%(51 cases), 97%(66 cases), 91%(62 cases), 82%(56 cases), 66%(45 cases), 69%(42 cases), and 61%(37 cases) respectively. The reasons why the children did not complete the vaccination plan were that parents were concerned about vaccination-induced seizures or seizures had not been controlled. Among 72 children with TSC, the rate of adverse events or suspected adverse events after vaccination was 17% (12 cases), which was higher than the normal control children (2 cases, 3%) (χ²=8.799, P<0.05). The main adverse events were seizure events, which accounted for 92%(11 cases). Conclusion The age-appropriate NIP coverage rate among children with tuberous sclerosis is low. The high incidence of adverse events may be associated with a fact that there are some nervous system abnormalities in cases with tuberous sclerosis. TSC children vaccination is relatively safe, with no serious adverse events.

Objective: To elucidate the mechanism of melatonin combined with cisplatin in promoting cell apoptosis of rat pancreatic cancer AR42J cells. Methods: Rat pancreatic cancer AR42J cells were divided into control group, 1 mmol/L cisplatin treated group (cisplatin group), 1 mmol/L melatonin treated group (melatonin group), 1 mmol/L cisplatin combined with 1 mmol/L melatonin treated group (combined group), 1 μmol/L cisplatin combined with melatonin treated group after 1 μmol/L PBN pretreatment for an hour (PBN+ combined group) and 1 μmol/L cisplatin combined with melatonin treated group after PBN solvent pretreatment for an hour (solvent+ combined group). MTT and annexin V-FITC/PI were used to detect the cell proliferation rate and cell apoptosis rate, respectively. The protein expression of caspase-3 was detected by Western blot. DCFH-DA was used to detect the level of ROS. ROS level and caspase-3 expression in AR42J cells pretreated with ROS antagonist PBN for 24 hours were detected. Results: The cell proliferation rate of control group, cisplatin group, melatonin group and combination group after 24-hour culture was (96.29±3.49)%, (81.38±6.01)%, (80.72±3.68)% and (42.26±6.35)%, respectively. The cell apoptosis rate was (16.42±4.15)%, (56.47±9.06)%, (52.94±6.57)% and (87.36±6.48)%, respectively. The percentage of ROS positive cells was (1.33±1.53)%, (46.67±7.64)%, (45.67±5.13)% and (83.33±7.64)%, respectively. The expression of cspase-3 was 100%, (150.64±7.70)%, (147.00±7.27)% and (190.04±5.07)%, respectively. The cell proliferation rate of cisplatin group and melatonin group was significantly lower than that of the control group. The apoptotic rate, the proportion of ROS positive cells and the expression of caspase-3 were significantly higher than those in control group. The changes in the combined group were more obvious than those in the single drug treatment group, and the differences were all statistically significant (all Pvalues <0.05). The percentage of ROS positive AR42J cells [(45.24±4.64)% vs (84.90±6.13)%)] induced by melatonin combined with cisplatin could be significantly reversed by PBN pretreatment for 1 hour, and the expression of caspase-3 in AR42J cells could be down regulated (124.92±9.72 vs 184.69±7.76) with statistically significant difference (all P values<0.05). Conclusions Melatonin combined with cisplatin may promote cell apoptosis of pancreatic cancer AR42J cells through ROS/caspase-3 pathway.